Impact of Integration of Multislice Computed Tomography Imaging into Three‐Dimensional Electroanatomic Mapping on Clinical Outcomes, Safety, and Efficacy Using Radiofrequency Ablation for Atrial Fibrillation

Martinek, Martin; Nesser, Hans‐Joachim; Aichinger, Josef; Boehm, Gernot; Pürerfellner, Helmut

doi:10.1111/j.1540-8159.2007.00843.x

Cited by 167 publications

(87 citation statements)

References 27 publications

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“…Our result thus con rms that RA volume is important for morbidity in patients with AF. Finally, MDCT is a guide to invasive intervention in patients with coronary artery disease 26,27 and rhythm disorders 14 , and our results indicated the signi cance of three-dimensional and quantitative evaluation of RA size using a computer-aided technique with 64-slice MDCT.…”

Section: Discussionsupporting

confidence: 51%

Right Atrial Volume Calculated by Multi-detector Computed Tomography: Useful Predictor of Atrial Fibrillation Recurrence after Pulmonary Vein Catheter Ablation

Kaneko

Akutsu

Kodama

et al. 2010

Showa Univ J Med Sci

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Section: Discussionsupporting

confidence: 51%

Right Atrial Volume Calculated by Multi-detector Computed Tomography: Useful Predictor of Atrial Fibrillation Recurrence after Pulmonary Vein Catheter Ablation

Kaneko

Akutsu

Kodama

et al. 2010

Showa Univ J Med Sci

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“…Twelve normal healthy volunteers were also recruited as the control group (age, 57Ϯ14 years; 41.7% men). Sixty-four-slice MDCT scans of the patients was performed systematically up to 48 hours before the procedure, for electroanatomic mapping integration, 16 PV anatomy delineation, and LA and RA volume estimations. All patients gave written informed consent before this study, and the protocol was approved by our institutional review board.…”

Section: Study Populationmentioning

confidence: 99%

Association Between Left and Right Atrial Remodeling With Atrial Fibrillation Recurrence After Pulmonary Vein Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Akutsu

Kaneko

Kodama

et al. 2011

Circ: Cardiovascular Imaging

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Background-Left atrial (LA) remodeling is a factor in atrial fibrillation (AF) recurrence after pulmonary vein catheter ablation (CA), but right atrium (RA) remodeling has not been investigated for possible associations to AF recurrence. Methods and Results-Using 64-slice multidetector computed tomography, RA and LA volumes were measured 3-dimensionally before CA in 65 patients with initially proven idiopathic paroxysmal AF (mean age, 60Ϯ10 years, 81.5% men). The CA procedure was guided by CARTO Merge atrial electroanatomic mapping. Sixteen patients (24.6%) had AF recurrence within the 6-month period after the CA.

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“…[4][5][6] Reconstructed 3DRA volumes correlate well with CT-derived volumes and can therefore be used as a substitute in this setting. Compared with CT, patient radiation exposure is reduced and can be brought to levels well below accepted values for interventional procedures.…”

Section: Three-dimensional Rotational Angiography As Computed Tomogramentioning

confidence: 91%

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

Potter

Bardhaj

Viggiano

et al. 2014

Arrhythm Electrophysiol Rev

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Percutaneous catheter treatment for atrial fibrillation (AF) has seen an exponential uptake since the first cases were published exactly two decades ago.1 Evolving over different approaches and treatment strategies, current standard of care consists of pulmonary vein isolation (PVI) through radiofrequency (RF) or other energy sources. While this treatment has been shown to be superior to pharmacological treatment in the setting of paroxysmal AF, considerable variation in reported outcomes exists.2,3 Part of this variation is attributed to the aforementioned change in strategies over time -a clear evolution exists from electrophysiology (EP)-guided (and anatomically rather straightforward) approaches such as trigger elimination inside the pulmonary veins (PVs) to more empirical creation of circular lesions around the PVs.3 This latter approach eliminates challenges such as trigger identification and reduces safety concerns such as PV stenosis, but introduces new complexities that are mostly related to catheter positioning in the complex three-dimensional (3D) space of the left atrium (LA).One of the peculiarities of catheter manipulation in the LA is the usefulness, or rather lack of usefulness, of basic two-dimensional (2D) fluoroscopy. Unlike conventional procedures (e.g. right atrial or ventricular manipulation), fluoroscopy landmarks for AF ablation are few and far between. On top of that, safe and successful PVI requires precise energy delivery at crucial complex 3D structures, such as the left superior PV left atrial appendage transition. In order to achieve this goal, several tools have been developed that either help the operator understand anatomy, facilitate 3D catheter navigation or decrease radiation exposure; and ideally combine several of these useful features. 4-7 Rotational AngiographyThree-dimensional rotational angiography (3DRA) is an innovative method that allows reconstruction of tomographic slices of a volume of interest in a manner similar to computed tomography (CT), using single-plane radiographic equipment. 8,9 The reconstructed 3D models can be used instead of conventional CT or magnetic resonance imaging (MRI) to complement non-fluoroscopic navigation systems, or can be overlaid on 2D fluoroscopic images. In contrast to CT/MRI this technology allows near realtime 3D imaging that is acquired during an ongoing ablation procedure, thereby avoiding volume mismatch due to changes in volume status, rhythm or even table geometry (influencing chest geometry). Not only does 3DRA offer advantages in terms of accuracy over pre-procedural imaging, it also has important benefits from a logistics and cost-effectiveness perspective. Table 1 lists the impact of 3DRA in different clinical scenarios, explained below. Table 2 lists the impact of different workflow options for 3DRA. Three-dimensional Rotational Angiography as Computed Tomography SubstituteAt its core, 3DRA is a technology that produces CT-like tomography slices.These slices can be used to perform measurements or -more commonly for EP pr...

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Impact of Integration of Multislice Computed Tomography Imaging into Three‐Dimensional Electroanatomic Mapping on Clinical Outcomes, Safety, and Efficacy Using Radiofrequency Ablation for Atrial Fibrillation

Cited by 167 publications

References 27 publications

Right Atrial Volume Calculated by Multi-detector Computed Tomography: Useful Predictor of Atrial Fibrillation Recurrence after Pulmonary Vein Catheter Ablation

Right Atrial Volume Calculated by Multi-detector Computed Tomography: Useful Predictor of Atrial Fibrillation Recurrence after Pulmonary Vein Catheter Ablation

Association Between Left and Right Atrial Remodeling With Atrial Fibrillation Recurrence After Pulmonary Vein Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

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